PEORIA — Of the $4.1 billion in backlogged payments, the state of Illinois is up to date on payments to medical transportation providers under a behavioral contract, though challenges remain.

“In any other month of the year and any other year in the last five, our Medicaid dollars, which constitute large blocks of expected payments ... have been out beyond 180 days,” Andrew Rand, chief executive officer of Advanced Medical Transport, said. “This year they’ve been within 90 days.”

The state’s payments have become more reliable, with a current outstanding balance of about $500,000 owed to AMT for services provided in the last 90 days, about half the amount owed two years ago when payments took twice as long.

The behavioral contract, which provides transportation for patients who can be violent or suicidal, constitutes about 10 percent of AMT’s operations and is classified as an essential service. With 80 percent of the behavioral services funded by state reimbursement, AMT qualifies for expedited payments.

“Every six months we renew a separate payment contract with the state of Illinois to keep our bills in the front of the line as opposed to the back of the line,” Rand said.

That preferential payment treatment is integral to operation for medical providers such as AMT because its services are always credited after an emergency, never paid in advance.

“That’s why health service providers have a unique disadvantage when any government payer gets behind as a routine matter, and that has been a challenge for many providers, especially in respect to Medicaid,” Rand said. “I’m not saying 90 days is current, but relative to 180 days in 2011, it’s much better.”

After falling further behind on state payments throughout recent years, AMT leaders put practices into place to limit delays on payments and avoid any disruption in operation.

“AMT has been in a situation where we’ve planned to have slower payments from state payers and don’t have a negative or adverse constraint to operating day-to-day,” Rand said.

While the expedited payments help smooth operations for AMT, when paybacks arrive they leave medical providers making up significant shortfalls, reimbursing 38 cents of every dollar spent on services, Rand said.

“It has absolutely nothing to do with timeliness. It has everything to do with the fact that it’s a program that’s never been correctly funded,” Rand said.

The funding for emergency medical services forces providers to bite the bullet and provide medical services to patients regardless of ability to pay.

But, much like the suspended payment problem of recent years, Rand hopes a solution is on the horizon for underfunded reimbursements.

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“There might actually be some light at the end of the tunnel as we make our case to legislators,” he said.

About this series

Reporters from GateHouse Illinois newsrooms examine the real-world effects of the state’s failure to pay its bills. Each Monday, we’ll share the stories of those affected.

By the numbers

$4,127,858,169.90* in general fund backlog as of Aug. 3

50,259 total bills delayed

*This figure only accounts for unpaid bills received by the comptroller’s office. The figure is much higher when including bills that have been sent to state agencies, but are yet to be forwarded to the comptroller for processing.